不同类型肝泡型包虫病灶边缘带ARFI检查与病理组织学相关性研究  

The marginal zone of different types of hepatic alveolar echinococcosis: ARFI and fibrosis area

作　　者：尹秋萍[1] 张玉英[1] 马钦风[1] 张静妮[1] 沈淼[1] 高莉[1] 黎娉[1] 李瑢 YIN Qiuping;ZHANG Yuying;MA Qinfeng;ZHANG Jingni;SHEN Miao;GAO Li;LI Ping;LI Rong(Department of Ultrasonography,People's Hospital of Qinghai,Xining 810007,China)

机构地区：[1]青海省人民医院超声科,青海西宁810007

出　　处：《医学影像学杂志》2023年第1期52-55,共4页Journal of Medical Imaging

基　　金：青海省卫健委医药卫生科研指导性课题项目(编号:2020-wjzdx-05)。

摘　　要：目的 探讨不同类型肝泡型包虫病(hepatic alveolar echinococcosis, HAE)边缘带声辐射力脉冲成像(ARFI)检查与纤维化面积的相关性。方法 选取肝泡型包虫病(AE)患者34例(39个病灶)常规超声筛查分为浸润型(16个)、钙化型(13个)及液化型(10个),通过ARFI中VTI技术测量病灶大小并分析硬度情况,利用VTQ技术测量不同类型病灶边缘带和周围正常肝脏组织的剪切波速度,所有病灶行常规HE染色、Masson染色,计数纤维化面积进行统计学分析。结果 VTI测量病灶最大直径大于常规超声测量大小(P<0.001),浸润型、钙化型、液化型HAE病灶边缘带SWV值差异具有统计学意义(F=56.343,P均<0.001),三种不同类型HAE病灶边缘区纤维化面积差异具有统计学意义(F=56.343,P均<0.001),无论是病灶边缘带SWV值还是纤维化面积,浸润型均与其他两型间存在统计学差异,并且低于其他两型。三种类型病灶边缘带SWV值与纤维化面积间均存在正相关关系(液化型:r=0.470,P<0.001;钙化型r=0.684,P<0.001;浸润型r=0.775,P<0.001)。结论 通过ARFI技术可以确定HAE病灶真实边界,同时区别不同类型HAE边缘带纤维化程度,浸润型HAE边缘带纤维化程度低于其他两型。Objective To investigate the correlation between marginal acoustic radiation force impulse imaging(ARFI) examination and fibrosis area in different types of hepatic alveolar echinococcosis(AE). Methods 34 patients(39 lesions) with confirmed hepatic AE were divided into infiltrated(16 cases), calcified(13 cases) and liquefied(10 cases) types by routine ultrasound screening, followed by the measurement of shear wave velocities in different types of lesions, marginal zone and surrounding liver tissues using VTQ technique. Finally, all the lesions were routinely subject to conventional HE and Masson staining, after which the fibrosis area was counted for statistical analysis. Results The maximum diameter of the lesions measured by VTI was larger than that measured by conventional ultrasound(P<0.001), and all the AE lesions(39 lesions) were stiffer than the background liver tissues during VTI measurement. The differences of SWV values(F=56.343, P<0.001) and fibrosis area(F=56.343, P<0.001) in the marginal zone of the lesions were statistically significant among the infiltrated type, calcified type and liquefied type. No matter the SWV value or fibrosis area of lesion marginal zone, there were statistical differences between the infiltrated type and the other two types, and the values of infiltrated type were lower. There was a positive correlation between SWV values and fibrosis area in the marginal zone of all three types of lesions(liquefied type: r=0.470, P<0.001;calcified type is r=0.684, P<0.001;liquefied type r=0.775, P<0.001). Conclusion The degree of fibrosis in the marginal zone of different types of hepatic AE can be distinguished by ARFI technique, and that of infiltrated hepatic AE is lower than that of the other two types.

关 键 词：肝 棘球绦虫 超声检查 弹性成像 病理学 

分 类 号：R383.3[医药卫生—医学寄生虫学] R445.1[医药卫生—基础医学]